Chemotherapy treatments are designed to target and destroy rapidly dividing cancer cells, but they often affect other quickly reproducing cells in the body, including the lining of the mouth and throat. This damage leads to a painful condition known as oral mucositis, characterized by inflammation, redness, and open sores on the mucous membranes. Managing this discomfort is paramount to maintaining nutrition and quality of life during treatment. These methods, which focus on gentle care and natural ingredients, can provide significant support, though they must always be discussed with the oncology team to ensure they align with the overall treatment plan.
Soothing Rinses and Topical Applications
Simple rinses formulated at home offer an immediate, non-irritating way to cleanse the mouth, reduce the bacterial load, and provide a protective layer over painful sores. A standard saline and baking soda rinse helps neutralize the mouth’s acidity and creates a mild, antiseptic environment that aids in healing. To prepare this, mix one teaspoon of salt and one teaspoon of baking soda into four cups of warm water, storing the excess solution at room temperature for up to one week. Patients should swish a small amount vigorously, gargle for 15 to 30 seconds, and then spit it out, repeating this process every four to six hours.
Because the rinse is isotonic and slightly alkaline, it is far less irritating than plain water or commercial mouthwashes. If the salt component causes stinging, a rinse made with only one teaspoon of baking soda in eight ounces of water may be preferred.
Natural honey has shown promise in reducing the severity of oral mucositis due to its anti-inflammatory, antibacterial, and tissue-healing properties. Honey, used in a “swish and swallow” manner, may help prevent or treat mouth sores in patients undergoing chemotherapy and radiation. A typical application involves using about one tablespoon (15 to 20 mL) of honey once or twice daily to coat the affected areas.
The thick consistency of honey allows it to form a soothing, temporary barrier over the ulcers, which can help reduce pain during eating and speaking. While it is generally well-tolerated, individuals with diabetes should monitor their blood sugar closely, and all patients must receive explicit approval from their oncologist before incorporating honey into their regimen. The natural sugars in honey can potentially increase the risk of oral fungal infections, making consistent oral hygiene even more important.
Dietary Adjustments for Comfort and Healing
When the mouth is sore and inflamed, the texture and temperature of food become significant factors in maintaining nutritional intake and preventing further irritation. Patients should focus on consuming foods that are soft, smooth, and easily swallowed, such as pureed fruits, creamy soups, and soft-cooked eggs. Incorporating moisture is essential, so adding sauces, gravies, or blending dry foods into liquids can make them far more palatable.
Avoiding foods with sharp edges or coarse textures, like crusty bread, chips, or raw vegetables, prevents mechanical injury to the delicate oral tissues. Similarly, foods and beverages that are chemically irritating should be strictly avoided. This includes highly acidic items, such as citrus fruits, tomatoes, and vinegar-based products, as well as spicy foods and strong seasonings.
Temperature extremes can also trigger pain receptors in the inflamed tissue, so all food and drink should be lukewarm or cool. Alcohol, found in some beverages and mouthwashes, and carbonated drinks are strong irritants that can cause immediate discomfort upon contact with the sores. By focusing on bland, nutrient-dense options like protein shakes, yogurt, and mashed avocados, patients can help ensure they receive adequate calories and protein for healing.
Essential Daily Oral Hygiene Practices
A gentle, consistent oral care routine is foundational to managing oral mucositis and minimizing the risk of a secondary infection. Patients should use a small, soft-bristle toothbrush, or even an extra-soft children’s brush, and brush gently two to three times a day. If toothpaste causes burning or pain, it can be temporarily replaced with a mild saline rinse for cleaning.
It is also important to clean between the teeth using unwaxed dental floss or an interdental tool, but this must be done with extreme care to avoid causing gum trauma or bleeding. Any dentures or dental prostheses must be cleaned thoroughly after each meal and removed while sleeping to allow the gums to rest.
Maintaining moisture in the oral cavity is another preventative measure, as dry mouth can worsen the pain and increase the chance of infection. Patients should sip water frequently throughout the day and use water-soluble lip moisturizers to prevent the lips from cracking. Alcohol-based mouthwashes should be avoided entirely, as the alcohol can dry out and irritate the already compromised tissues.
Internal Support Through Supplements
The amino acid L-Glutamine is a primary fuel source for the rapidly dividing cells of the gastrointestinal tract, and supplementing it is thought to potentially limit damage by providing the building blocks for cellular repair. Studies have suggested that oral L-Glutamine, often administered as a powder mixed with water in a “swish and swallow” manner, can reduce the severity and duration of chemotherapy-induced mucositis.
Typical dosing regimens for L-Glutamine range, but some clinical trials have used up to 10 grams taken three times a day, though the optimal dose can vary based on the specific treatment protocol. Zinc is another mineral that has been studied for its role in mucosal health, particularly in cases involving radiation therapy, due to its function in cell proliferation and wound healing.
Supplements are not regulated as treatments, and introducing them can sometimes interfere with the efficacy of cancer drugs. Therefore, the use of L-Glutamine, Zinc, or any other supplement must be discussed and approved by the treating oncologist first. The oncology team can provide a specific dosage and ensure the compound does not negatively interact with the chemotherapy regimen.